It is essential to visit a doctor when symptoms of diabetes appear in children, to ensure early detection of the disease and avoid its development into type 2, or any complications that may lead to death or amputation of a limb. This article, through the Dalili Medical website, reviews the most prominent symptoms associated with diabetes in children, whether type 1 or type 2, in addition to explaining methods for diagnosing and treating the disease, and providing comprehensive information about the potential complications that may affect diabetics.

**What is type 2 diabetes?**

 

Type 2 diabetes is a chronic disorder that affects the body's ability to metabolize glucose, which is the main source of energy. This disorder leads to high levels of glucose in the blood, and is also known as non-insulin-dependent diabetes, and usually affects adults, but it may also appear in children as a result of certain factors.

**Facts about type 2 diabetes in children**

 

It was not common a few years ago to hear about children with type 2 diabetes, as it was believed that only children were affected by type 1. However, global health statistics have shown a significant increase in the number of children with type 2 diabetes. In this type of diabetes, the child's body cells do not respond to insulin, which leads to a buildup of glucose in the bloodstream, known as insulin resistance. As a result, blood sugar levels rise significantly, which can lead to health problems if the condition is not managed properly.

**Type 2 Diabetes in Children**

 

Type 2 diabetes develops when the pancreas does not produce enough insulin, or when the body does not respond to insulin properly, leading to insulin resistance and a buildup of glucose in the blood. This type of diabetes in children often develops gradually, making it difficult to notice its symptoms. The causes of type 2 diabetes in children are closely linked to being overweight and having high blood sugar levels. Therefore, it is important to diagnose type 2 diabetes in children as soon as symptoms are noticed and start treatment as soon as possible to avoid complications.

Treatment of type 2 diabetes in children depends on the progress of the condition. In the early stages, insulin resistance can be reduced or its worsening can be limited and blood sugar levels can be controlled through lifestyle changes, such as losing excess weight, eating a balanced diet, and exercising.

**Symptoms of type 2 diabetes in children:**

 

Symptoms of type 2 diabetes in children include:

- Frequent urination, especially at night.

- Itching around the genitals, which may be accompanied by a fungal infection.

- The appearance of dark, velvety spots on the skin known as acanthosis nigricans.

- Recurring bladder infections.

- Skin infections and difficulty healing wounds.

- Itchy skin.

- Increased need to urinate.

- Weight loss despite the child's increased appetite.

- Increased thirst.

- Vision problems.

- The child feels weak and tired.

- Mood swings and irritability.

- Nausea and vomiting.

- Tingling or loss of sensation in the hands or feet.

- Dark areas appearing on the child's skin, often around the neck or in the armpits and groin.

- High blood and urine sugar levels when testing.

 Risk factors for type 2 diabetes in children

 

Researchers still don't understand why some children develop type 2 diabetes while others remain immune, even with similar risk factors. However, there are some factors that are considered to increase the risk, including:

- **Being overweight**: Obesity is one of the most prominent risk factors for type 2 diabetes in children. The more body fat, especially in the abdominal area, the more resistant the body's cells are to insulin.

- **Physical inactivity**: The less active a child is, the more likely he or she is to develop type 2 diabetes. Physical activity helps control a child's weight by using glucose as a source of energy, which makes the body's cells more responsive to insulin.

- **Family history**: Children are at increased risk of developing type 2 diabetes if a parent or sibling has the disease.

- **Race**: Although the reasons are not clear, some groups, such as blacks, Hispanics, American Indians, and Asian Americans, are at higher risk of developing type 2 diabetes.

- **Age and gender**: It is noted that many children develop type 2 diabetes in early adolescence, with girls being more susceptible than boys.

- **Birth weight and gestational diabetes**: Low birth weight or being born to a mother with gestational diabetes is associated with an increased risk of type 2 diabetes.

- **Premature birth**: Children born prematurely (before 39 to 42 weeks of pregnancy) have a greater risk of developing type 2 diabetes.

Do the symptoms of diabetes differ between children and adults?

 

Diabetes shows a group of symptoms in children, adolescents and adults, and these symptoms do not vary based on the age group of the patient, but rather depend on other factors, most notably the type of disease the individual has. There are two types of diabetes, the first is characterized by mild symptoms, while it develops into type 2, which may show more severe symptoms in some cases.

What are the signs of type 2 diabetes in children?

 

 

Diabetes in children can develop into type 2 diabetes, which is accompanied by more severe symptoms, although there are some similarities between the symptoms of both types. The following symptoms indicate type 2 diabetes in children:

- **Extreme fatigue**: Children's blood sugar levels affect their ability toTheir death, which leads to feeling unusually tired and sleepy, which is one of the symptoms that appear when the disease develops into type 2.

- **Slow wound healing**: Wounds and ulcers heal slowly in type 2 diabetes patients compared to non-diabetics, so the patient must take care of these wounds to avoid serious complications.

- **Frequent urination**: Children with type 2 diabetes suffer from frequent trips to the toilet due to the increased sugar content in the urine, when blood sugar levels rise.

- **Extreme thirst and hunger**: Excessive thirst results from high blood sugar levels, while insulin deficiency leads to a feeling of excessive hunger in type 2 diabetes patients.

- **Dark skin color**: Imbalanced insulin levels in the body of type 2 diabetes patients leads to darkening of the skin color, and this often appears in the neck and underarm area, and may also appear in other areas of the body.

- **Blurred vision**: Vision becomes blurry in people with type 2 diabetes when blood sugar levels rise significantly, which leads to fluid being drawn from the eyes and affecting the clarity of vision.

**How ​​to deal with diabetes symptoms in children**

Diabetes symptoms in children can be managed through the following steps:

1. **Insulin**: Children with diabetes must take insulin, which helps glucose move in the blood and provide the energy needed by the body to perform its various functions. There are several ways to take insulin, the most prominent of which is injections.

2. **Following an appropriate diet**: All people with diabetes should adhere to a balanced diet to maintain blood sugar levels. This requires developing a meal plan and calculating the amount of carbohydrates in each meal according to the doctor's instructions.

3. **Exercise**: Sports activities can help diabetics maintain normal blood sugar levels. It is also necessary to receive appropriate treatment recommended by the doctor to avoid complications of diabetes symptoms in children.

4. **Avoid physical activity problems**: People with type 2 diabetes may face difficulties while exercising or other activities. Therefore, precautions should be taken to avoid these problems, such as eating snacks before activity.

5. **Follow instructions when taking medications**: Exercise and a healthy diet can help maintain appropriate blood sugar levels, but the patient must adhere to the doctor's instructions regarding taking medications, taking care not to increase or decrease the doses.

6. **Monitoring blood sugar levels**: Type 2 diabetes patients must monitor blood sugar levels continuously to take appropriate measures in a timely manner, as delaying treatment may lead to the appearance of serious symptoms.

**Who is most at risk for type 2 diabetes?**

 

Type 2 diabetes is likely to affect children in the following categories:

- Girls

- Overweight children

- Those with a family history of diabetes

- Children of American Indian, African, or Asian descent

- Those with insulin resistance

One of the most prominent causes of diabetes in children is being overweight. In the United States, one in three children is overweight, and when weight increases, the likelihood of developing diabetes doubles. There are several factors that may contribute to weight gain, including:

* Eating unhealthy foods.

* Lack of physical activity.

* Having a family member who is overweight.

* In rare cases, there may be hormonal problems or other medical conditions.

**Preventing type 2 diabetes in children**

 

Healthy lifestyle choices can help prevent type 2 diabetes in children. If your child already has this type of diabetes, lifestyle changes may reduce the need for medication and reduce the risk of complications. You can encourage your child to:

• Eat healthy foods: Offer him low-fat and low-calorie options, and focus on fruits, vegetables, and whole grains, while ensuring variety to avoid boredom.

• Increase physical activity: Encourage your child to be active, whether by signing him up for a sports team or thinking of activities you can do together.

**Challenges that children with diabetes may face:**

 

• Social challenges: Some children may feel isolated or embarrassed because they need to take insulin or measure their blood sugar in front of their peers.

• Educational challenges: A child may need to leave the classroom frequently to take insulin doses or eat snacks to control their blood sugar levels.

**Psychological impact of diabetes on children:**

 

Children may feel frustrated, scared, or angry because of their illness. Therefore, open communication with children and seeking psychological support can have a significant positive impact.

**Psychological support for children with diabetes:**

 

It is essential for children with diabetes to receive psychological support, whether by joining support groups or seeking psychological counseling services.

**Coping with diabetes in children:**

 

- **Education:** It is essential to teach children about diabetes and ways to control it effectively.

- **Encouraging independence:** The child should be taught how to measure blood sugar levels and take insulin independently.

- **Planning:** Be prepared for emergencies, such as low blood sugar.

**Family and school support for children with diabetes:**

 

- **Understanding the condition:** Family members and teachers should be familiar with the child's condition and understand the symptoms that may indicate problems with blood sugar levels.

- **Creating a supportive environment:** It is important to provide an environment that encourages the child to talk about his or her illness and seek help when needed.

**Dealing with children with diabetes at school:**

 

- **Health care plan:** Parents should communicate with the school to explain the child’s needs and provide a care and emergency plan.

- **Teacher training:** Teachers and supervisors should be aware of how to deal with emergencies such as hypoglycemia.

- **Snacks:** Children should be allowed to have snacks throughout the day to avoid fluctuations in blood sugar levels.

**New research and potential treatments for diabetes in children:**

 

Research continues to explore new treatments for diabetes, including attempts to transplant pancreatic cells or use stem cell therapy to restore the body’s ability to produce insulin.

Dealing with diabetes in childhood requires ongoing effort from children and their families. With education and support, children with diabetes can live normal, active lives and cope with the challenges that their condition presents. Diabetes in children is a daily challenge that requires careful care and attention. Continued support from family and community, in addition to education and awareness about the disease, can contribute to improving the quality of life of affected children and enhancing their independence.

**Complications of type 2 diabetes in children**

 

The long-term complications of type 2 diabetes in children develop gradually over several years, and these complications include the following:

- High cholesterol levels.

- High blood pressure.

- Cardiovascular disease.

- Kidney problems.

- Eye disease, which may lead to blindness.

- Risk of stroke.

- Nerve damage.

- Eating disorders.

**Heart disease:** Diabetes can lead to a range of cardiovascular diseases, such as narrowing of the vessels and increased levels of triglycerides and low-density lipoprotein cholesterol.

**Nerve damage:** Nerve damage occurs as a result of damage to the walls of blood vessels caused by diabetes, which affects the nutrition of the nerves. Symptoms of this damage include tingling, burning, or pain.

**Osteoporosis:** Diabetes causes low levels of minerals in the bones, which increases the risk of developing osteoporosis in the future, a complication that may also affect adults.

**Eye damage:** In some cases, diabetes can damage the blood vessels that supply the eye, leading to vision problems or even blindness.

**Diabetic ketoacidosis:** It is considered a serious complication that threatens the life of the child, as it occurs when the body begins to break down fats for energy due to a lack of insulin.

**Hyperglycemia:** The risk of hyperglycemia increases in adults, and it can also affect children. It is a rare and serious condition that requires emergency treatment, and is accompanied by symptoms such as extreme thirst, hallucinations, loss of vision, and weakness on one side of the body.

**High blood pressure:** High blood pressure is a complication of diabetes, and can lead to other problems such as vision, kidney, heart, and brain problems, so blood pressure should be monitored constantly to avoid these complications.

**Stroke:** Stroke usually occurs when blood clots block blood vessels in the brain, and high blood pressure, excess fat, and obesity are contributing factors.

**Foot ulcers:** Some diabetics may develop foot ulcers and fungi as a result of nerve damage and circulatory problems. These ulcers must be treated to avoid the risk of foot amputation later.

**Kidney damage:** Diabetics can suffer kidney damage as a result of damage to the blood vessels responsible for purifying the blood of waste, which is a common complication in children with diabetes.

**Gastroparesis:** If blood sugar levels remain high for a long time, the vagus nerve, which controls the movement of food through the digestive system, may be damaged, leading to a condition known as gastroparesis.

**Psychological illnesses:** The exact reason for the association of diabetes with some psychological illnesses has not been determined, but those with this disease are more prone to depression, anxiety, and stress than others.

**Dementia:** Research suggests that diabetes is linked to some diseases associated with dementia, such as mild cognitive impairment, Alzheimer's disease, and vascular dementia.

**How ​​is type 2 diabetes diagnosed in children?**

 

If parents notice some of the symptoms mentioned above, they should consult a specialist doctor. The doctor will measure the child's weight and height, calculate body mass index, and assess his growth on a growth curve. The doctor will then order some tests. If the fasting blood sugar result is above 126 mg/dL, or the glycated hemoglobin test result is above 6.5%, the child will likely be diagnosed with diabetes. To determine whether the child has type 1 or type 2 diabetes, the doctor will order a GAD antibodies test.

**What are the medications for treating type 2 diabetes in children?**

 

The Food and Drug Administration (FDA) has approved three medications to treat type 2 diabetes in children, which are:

1. **Metformin**: Metformin tablets work to reduce the amount of sugar that the child's liver releases into the bloodstream between meals, and it also helps the body's cells use insulin more effectively.

2. **Liraglutide**: This medication is given by injection, and it helps the body secrete more insulin from the pancreas after meals, when blood sugar levels are high.

3. **Insulin**: The child may need insulin in some cases if blood sugar levels are very high, but there is no need toWith lifestyle changes and other medications, your child may be able to stop using insulin.

**Treatment**

Treatment for both types of diabetes is lifelong and may include:

- Eating a healthy diet

- Regular physical activity

- Using insulin or other medications

- Monitoring blood sugar levels

- Weight-loss surgery in some cases

Parents will work closely with their child's diabetes treatment team, which includes a doctor, a certified diabetes care specialist, a registered dietitian, and other specialists as needed. The goal of treatment is to keep your child's blood sugar within a specific range, helping them get closer to normal.

The child's doctor will tell parents what their target blood sugar range is and may also set a target hemoglobin A1c level. These numbers may change as your child grows and changes, which may require adjusting their treatment plan.

**Healthy Eating Pattern**

Nutrition is an essential part of any diabetes treatment plan, but that doesn’t mean your child should be on a “diet.” Your doctor may recommend that your child lose weight to reach and maintain a healthy weight, which can help improve blood sugar levels.

Your child’s dietitian may suggest that your child and family eat foods that are high in nutrients and low in fat and calories.

A healthy diet includes plenty of fruits, vegetables, nuts, whole grains, and olive oil. Choose foods that are low in fat and calories and high in fiber. Be sure to vary your foods to meet your child’s goals while considering taste and nutritional quality.

Your dietitian will help you develop a meal plan that fits your child’s food preferences and health goals, and will suggest how much dessert to offer occasionally. Your dietitian may also recommend:

- Limit portion sizes and avoid emptying your plate.

- Eat fruits or vegetables instead of carbohydrate-rich foods.

- Drink water instead of high-calorie drinks, such as soda or fruit juice.

- Reduce your mealtimes, and eat most of your meals at home.

- Involve your children in preparing meals.

- Eat meals at the table instead of while watching TV.

**Physical activity**

Everyone, including children with type 2 diabetes, needs regular aerobic exercise. Physical activity helps children control their weight, as it burns sugar for energy and helps the body use insulin more effectively, which leads to lower blood sugar levels.

Make physical activity part of your child’s daily routine. It doesn’t have to be done all at once, but you can break it up into short periods. It’s important to encourage your child to do at least 60 minutes of physical activity a day, and it’s best to do the activity with them to encourage them.

**Medications for treating type 2 diabetes in children**

The U.S. Food and Drug Administration has approved three medications to treat type 2 diabetes in children:

1. **Metformin (Glumetza and others)**: This medication reduces the amount of sugar your child's liver makes into the blood between meals, and helps your body's cells use insulin more effectively.

2. **Liraglutide (Victoza)**: This medication is given by injection and helps your body make more insulin from your pancreas after eating, when your blood sugar level is high. This medication may cause some gastrointestinal side effects, such as nausea or diarrhea.

3. **Insulin**: In some cases, your child may need to take insulin if their blood sugar levels are too high. Insulin helps sugar enter cells to produce energy, which reduces the amount of sugar in your bloodstream. There are different types of insulin, but long-acting insulin given once a day, along with short- or rapid-acting insulin given with meals, is most often used to treat type 2 diabetes in children. Insulin is usually given by injection or with an insulin pen. Your child can also get off insulin by making lifestyle changes and using other medications.

**Blood sugar monitoring**

The doctor will determine how often you or your child should check and record their blood sugar. Children who receive insulin usually need to test more frequently, up to four times a day or more. Depending on their treatment needs, monitoring glucose levels more frequently may be an option. Frequent testing is the only way to ensure that your child’s blood sugar stays within their target range.

**Weight-loss surgeries**

These procedures aren’t right for everyone, but for teens who are severely obese (BMI 35 or higher), weight-loss surgery may help improve control of type 2 diabetes.

**Ongoing medical care**

Your child should see their doctor regularly to make sure their diabetes is well controlled. Visits may include checking their blood sugar patterns, eating habits, physical activity, weight, and medications they take. Healthy lifestyle changes can reduce the need for medications.

Your doctor may also check your child's hemoglobin A1c levels. The American Diabetes Association recommends that all children and teens with diabetes have a hemoglobin A1c level of 7% or less.For diabetes.

The doctor will perform regular checkups for your child, including:

- Growth

- Blood pressure

- Cholesterol levels

- Liver and kidney function

- Eyes (usually annually)

- Feet

- Risk of polycystic ovary syndrome and obstructive sleep apnea

Your child's doctor will likely recommend that your child receive a yearly flu shot, and may also recommend a pneumonia vaccine and a COVID-19 vaccine if your child is 5 years or older.